角膜屈折矯正手術後に眼位が増悪し斜視手術を施行した2例

Aggravation of strabismus in two cases following keratorefractive surgery

要約　目的：角膜屈折矯正手術後に斜視が増悪した2症例の報告。症例：症例はそれぞれ21歳女性と43歳男性で，1例は1年前にLASIK，他の1例は16年前に不同視に対し，一眼に屈折矯正角膜切除術（PRK）を受けた。1例では手術後に両眼が遠視化し，術前からあった間欠性内斜視が恒常化して斜視手術を必要とした。他の1例には近視性不同視と間欠性外斜視があった。眼精疲労を伴う斜位近視と診断し，斜視手術を行った。結論：角膜屈折矯正手術では術後に眼位または両眼視機能が増悪することがあり，術前に眼位と両眼視機能を評価し，複視を含む病歴聴取が必要である。

Abstract.　Purpose：To report two cases who showed aggravation of strabismus after keratorefractive surgery. Cases：The present series comprised 21-year-old female and 43-year-old male. One underwent LASIK one year before and the other had received refractive keratectomy（PRK）in one eye for anisometropia 16 years before. In the first case,both eyes became hypermetropic and intermittent esophoria became permanent after surgery needing strabismus surgery. The other case showed myopic anisometropia and intermittent exotropia. He was diagnosed with phoria-myopia with asthenopia and received strabismus surgery. Conclusion：The present cases illustrate that keratorefractive surgery may be followed by aggravation of phoria or binocular function. We advocate detailed evaluation of eye position,binocular function and history about diplopia before surgery.